Sunday, 12 May 2013

I've been thinking about lifestyle choices and health

So, here's the thing. I've made choices in my life that I know could have a negative impact on my health. I'm not going to include here the stuff that I think are symptoms of my mental health disorders. So, I am going to be talking about yo-yo dieting, smoking and drinking but not binge eating, purging, starving myself or self injury. I guess the thing I'm interested in here is about the right to judge others on their lifestyle choices, specifically blaming people for their health problems. Particularly those linked to obesity, smoking and alcohol.

So then, the message that these things are unhealthy is pretty much everywhere isn't it? I find it hard to believe that anyone living in the west can really claim to be unaware of the idea that smoking is linked to cancer, or poor diet to obesity and so on. So why do we still eat food that's bad for us? Why do we keep dieting, when it's been fairly widely reported that people who diet tend to end up gaining rather than losing weight in the long term? Why do we smoke when it smells bad, costs loads and has been linked to cancer? Why do we drink when it leads to making rash and sometimes dangerous decisions, can lead to liver disease and in the case of binge drinking can kill you in a matter of hours.

I certainly know all this stuff, yet until recently I not only drank but often drank to excess. I smoke on occasion and have been a heavy smoker historically. And I'm on a diet right now, despite knowing it won't really work, except in the very short term if I can even stick with it that long. So, knowing all of this why would I still do it? Simple. After a quick risk assessment, these things seem a viable option.

OK, let me talk you through it. I haven't been out in ages, my friends are beyond annoyed with me cancelling at the last minute and have started drifting away. I'm genuinely worried that I'll soon lose them, which would mean losing most of my support network. Plus, humans are social creatures, we don't function well without the company of others. Having been in 'hide from the world mode' for a while now, my mental health is starting to further deterioate. Now, I know when I drink I can also engage in risky behaviour - such as spending my taxi money on more drinks - and will almost certainly end up throwing up. I also know that since I'm likely to end up binge drinking there's a chance of passing out, injuring myself and/or ending up in hospital. Or having an alcohol induced seizure. This is never fun, Never. But, without the temporary confidence alcohol gives me I know I'm not likely to leave the house, never mind make it to the club and actually engage in that whole social interaction thing. So, despite the risks drinking seems like a viable option. The risks to my health, if I further damage my friendships and continue to remain socially isolated and lonely seem greater. They include suicide, for a start.

What about smoking? Well, I'll be honest. I don't think I'm going to live to a ripe old age anyway. Plus, as part of my anxiety I tend to imagine I have every single serious illness I've ever heard of. There are weeks I think I'm about to die from a heart attack, have a brain tumour or MS on an almost daily basis. Worrying about long term or terminal illnesses is so normal for me that the genuine risk from smoking doesn't really change anything. On the other hand, nicotine can act as a mild anti-depressant, it's one of the few things I enjoy when in a depressive or anxious state and in the past when I smoked heavily, needing a cigarette was sometime the only thing that would get me out of the house, even if was only to go as far as the off licence across the road.

Smoking has often been my go to place when I feel the urge to self harm or kill myself. Killing myself has the most obviously damaging effect on my health. Self injury often calms down or removes the urge to take that step, so I consider it the better option. Self harm can get out of hand though, it's possible to cut too deeply and end up needing stitches or permanently damaging something. It's possible to make a mistake and kill yourself by accident. Smoking can often reduce or remove the urge to self harm, or so I have found. Plus, sometimes self injury isn't enough to help me fight off the suicidal urges. And sometimes smoking isn't enough to stop me self harming. I find it's better to start with smoking, as if that doesn't work my go to place is self harm. And at that point, if I still feel suicidal I'm at least more likely to be calm enough to get some help. Given the choice to definitely hurt myself right now or to do something which is probably harming my health long term, I'll chose to avoid the immediate danger. Because protecting my long term health only matters if I'm going to be here in the long term.  It's sad that so much of my life is spent finding ways to fight the urge to end it, but there it is.

Dieting is the same. I know I'm picking the short term benefit over the long term health problems. I do know that, but the thing is that wanting to lose weight is a more immediate concern. The thinking behind this one is that once I start losing weight, I stop feeling quite so anxious and that makes it easier to get on with doing more useful stuff - such as dealing with the underlying anxiety, getting a new job or not giving in to the urge to hurt myself.

Now, I'm not saying everyone is in the same situation. Of course they aren't. What I am saying is that people make these decisions for all kinds of reasons which aren't obvious just by looking at someone. Heck, a lot of the time they aren't obvious to the people making them. I just find it difficult to believe that anyone wants to be unhealthy, so I never think that what they are choosing is to make themselves ill. I think what people are doing is choosing to fulfil a current need over worrying about a future one and we shouldn't judge them until we know their reasons. Maybe not even then.

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